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Background  Ascending aortic aneurysms are one of the major causes of mortality. In recent years, there is a growing interest of epicardial adipose tissue (EAT) and related diseases. The aim of this study was to investigate the relationship of EAT, and PAT with ascending aortic dilatation (AAD).    Methods  We included 934 patients with hypertension in this study .  The patients were evaluated by a complete transthoracic echocardiographic examination, including measurements of EAT, PAT, and aortic dimensions. Aortic size index (ASI) was used for diagnosing AAD. The patients were divided into two groups: dilated ascending aorta diameter (ASI ≥ 21 mm / m 2 ,  n  = 102) or normal aortic diameter (ASI < 21 mm / m2,  n  = 832) according to the ASI. Characteristics of these patients were compared before and after propensity score matching analysis.    Results  Patients with AAD were older (72.3 ± 11.6 vs. 61.7 ± 12.7 years,  p  <  0.001), had more female gender (66% vs. 54%, p  = 0.021) than patients with normal ascending aorta (AA). After propensity score matching analysis (77 vs .  77), EAT [OR:1.461, %95CI (1.082–1.974),  p  = 0.013] was independently associated with AAD in multivariate logistic regression analysis. In ROC curve analysis, EAT > 0.45 cm had 51.9% sensitivity and 62.3% specificity [AUC = 0.617,  P  = 0.012, 95% CI (0.529–0.707)].    Conclusion  Based on our findings, increased EAT may be suggested as an independent risk factor for AAD due to local or systemic effects in hypertensive patients.

Epicardial adipose tissue is a predictor of ascending aortic dilatation in hypertensive patients, but not paracardial adipose tissue